Acne triggered by testosterone therapy varies from person to person. That means there isn’t a universal answer to how long it lasts. Here’s what we know and some treatment tips, like home remedies, drugstore products, and more.
Some people may have initial breakouts as their bodies adjust to new hormone levels, and that’s it. Others may navigate breakouts for the first 6 to 12 months of testosterone therapy.
And some will deal with acne for as long as they take testosterone.
Ultimately, it depends on the chemistry of your skin, your prescribed dosage of testosterone, and what acne treatments, if any, you currently use.
Ahead, learn why testosterone therapy can cause acne and what you can do to help prevent and treat it.
“Taking testosterone can increase sebum production,” explains Anna Chacon, MD, a dermatologist based in Miami, Florida.
Sebum is an oily, waxy substance produced by the sebaceous glands, she explains. If your body suddenly produces more sebum than usual, your sebaceous glands are more likely to become irritated or clogged.
“It’s common for acne to erupt as a result of these irritated sebaceous glands,” says Chacon.
The amount of testosterone you take may also play a role.
“Clinical experience seems to indicate that higher doses might contribute to more problems with acne,” says Michelle Forcier, MD, a gender-affirming clinician with virtual healthcare service FOLX.
If you have a breakout but don’t have time or transportation to a drugstore, you can create your own treatment.
Chacon recommends:
- Create a mixture with 1 part apple cider vinegar and 3 parts water.
- After rinsing your face with water, gently apply the mixture to the skin using a cotton ball.
- Allow for 5 to 20 seconds before rinsing with water and patting dry.
- Repeat this technique 1 to 2 times each day, as needed.
This can be effective for mild acne, she says, but likely won’t cut it for more severe outbreaks.
“Most of the time, this acne responds to common over-the-counter remedies,” says Chacon.
There are a few main types of over-the-counter treatments that can be effective, explains Viktoryia Kazlouskaya, MD, a dermatologist with Khrom Dermatology in Brooklyn, New York.
Kazlouskaya recommends products with:
“Benzoyl peroxide is probably the most known over-the-counter remedy,” says Kazlouskaya. Look to products from PanOxyl, Cerave, Paula’s Choice, and Clean and Clear, to name just a few.
“Salicylic acid washes, like Neutrogena Oil-Free Acne Wash, and azelaic acid washes, like The Ordinary Azelaic Acid Suspension 10% and Naturium Azelaic Acid Emulsion 10%, are also great,” she says.
La Roche Posay also makes an over-the-counter topical retinoid that’s effective, Kazlouskaya adds.
There are many prescription-strength medications that a dermatologist or other healthcare professional could prescribe to help testosterone-related acne.
Some experts commonly prescribe isotretinoin to treat severe acne. It’s better known by the names of the brands that carry it:
- Accutane
- Absorica
- Amnesteem
- Claravis
- Myorisan
- Zenatane
A dermatologist will work with you to determine how long your course of medication should be.
On average, people take isotretinoin for at least 5 months, says Forcier. “It really can help some people with severe acne, and after a course of treatment, it often goes away for the rest of their lives.”
Isotretinoin isn’t the only prescription option, however.
“A prescription topical retinoid, topical antibiotic with benzoyl peroxide, or oral antibiotic should also be explored as treatment options,” says Chacon.
In some cases, a contraceptive pill is also an option for treating acne.
“The FDA approved contraceptive pills with ethinyl estradiol for treating acne,” says Chacon. This medication helps limit acne that occurs due to hormone fluctuations.
Sometimes oral contraception is prescribed with an anti-androgen medication like spironolactone (Aldactone), notes Chacon. This can help stabilize your testosterone levels and reduce the amount of sebum.
Contraceptive pills and anti-androgen medications may not be an option for people who are currently taking testosterone therapy but may be useful for folks who have recently stopped.
These medications may also be used for folks who have higher levels of naturally occurring testosterone.
Be sure to talk with your healthcare professional about medications you currently take before starting a new medication or treatment.
Adopting various hygiene and healthy lifestyle habits may help you manage testosterone-related acne.
First up: Avoid soaps, shampoos, conditioners, and face washes that are fragrant or contain alcohol, suggests Forcier.
Anything that washes over your face or body in the shower can cause further irritation to the sebaceous glands and, therefore, worsen acne, she explains. Opting for gentle, fragrance-free soaps and cleansers is a good idea.
Next, avoid touching your face as much as possible. And if you need to touch your face? Wash your hands first! “Your hands and fingers will transmit oil and dirt to your face, which can worsen acne,” says Forcier.
Finally, it’s generally considered wise to eat nutrient-dense food, stay hydrated, and limit drug and alcohol intake, says Chacon.
Testosterone therapy can boost your body’s sebum production, which can clog pores and lead to pimples. But with proper planning and care, testosterone-related acne is treatable and preventable.
Talk with a healthcare professional to come up with a skin and lifestyle protocol that works best for you, your body, and your health goals.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.
